Provider Demographics
NPI:1548697972
Name:COOK-CORNMAN, SHEILAN (LPC)
Entity type:Individual
Prefix:MS
First Name:SHEILAN
Middle Name:
Last Name:COOK-CORNMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHEILAN
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:16060 COUNTY ROAD 1050
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:MO
Mailing Address - Zip Code:65559-8679
Mailing Address - Country:US
Mailing Address - Phone:573-205-9662
Mailing Address - Fax:
Practice Address - Street 1:110 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:MO
Practice Address - Zip Code:63080-1910
Practice Address - Country:US
Practice Address - Phone:573-205-9662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional